PMID- 22875736
OWN - NLM
STAT- MEDLINE
DCOM- 20130411
LR  - 20130128
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 99
IP  - 4
DP  - 2013 Feb
TI  - Impact of intracoronary cell therapy on left ventricular function in the setting 
      of acute myocardial infarction: a meta-analysis of randomised controlled clinical 
      trials.
PG  - 225-32
LID - 10.1136/heartjnl-2012-302230 [doi]
AB  - CONTEXT: Numerous randomized controlled studies assessing intracoronary bone 
      marrow cell therapy (BMC) after acute myocardial infarction (AMI) have been 
      performed. OBJECTIVE: To systematically review the effect of autologous BMC 
      therapy on left ventricular function by performing an up to date meta-analysis of 
      randomized controlled trials (RCTs) including long-term follow-up. DATA SOURCES: 
      Trials were indentified through a literature search from 1980 to June 2012 of the 
      Pubmed, Embase, Cochrane database, and the Current Controlled Trials Register. 
      STUDY SELECTION: Randomized clinical trials comparing intracoronary BMC infusion 
      to control as treatment for AMI. DATA EXTRACTION: The primary endpoint was the 
      change in left ventricular ejection fraction (LVEF) from baseline to follow-up. 
      Secondary endpoints were changes in left ventricular end diastolic volume 
      (LVEDV), left ventricular end systolic volume (LVESV), infarct size and clinical 
      outcomes. RESULTS: Improvement of LVEF in patients receiving intracoronary BMC 
      was significantly better within 6 months (23 studies, 2.23% (95% confidence 
      interval (CI) 1.00 to 3.47); p<0.001). At 12 months of follow-up, this effect 
      sustained with 3.91% more LVEF improvement (11 studies, (95% CI 2.56 to 5.27), 
      p<0.001). At long-term follow-up, we found a trend for better LVEF improvement in 
      favor of cell therapy (7 studies, 1.90% (95% CI -0.43 to 4.23); p=0.11). There 
      was no clear effect in infarct size or LVEDV. However, we found a significant 
      reduction in LVESV at 6 months (-4.81 ml (95% CI -7.86 to -1.76); p<0.001 and at 
      12 months (-9.41 ml (95% CI -13.64 to -5.17); p<0.001). Moreover, there was a 
      statistically significant decrease in recurrent AMI (Relative Risk (RR) 0.44 (95% 
      CI 0.24 to 0.79); p=0.007), and readmission for heart failure, unstable angina or 
      chest pain (RR 0.59 (95% CI 0.35 to 0.98); p=0.04) in favour of cell therapy. 
      CONCLUSION: Intracoronary BMC treatment leads to a moderate improvement of LVEF 
      and reduction of LVESV at 6 months that sustained at 12 months follow-up, without 
      a clear significant effect on LVEDV, or infarct size. Furthermore, we found that 
      intracoronary cell therapy is significantly associated with a reduction in 
      recurrent AMI and readmission for heart failure, unstable angina or chest pain.
FAU - Delewi, Ronak
AU  - Delewi R
AD  - Department of Cardiology, Academic Medical Center, University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - Andriessen, Anouk
AU  - Andriessen A
FAU - Tijssen, Jan G P
AU  - Tijssen JG
FAU - Zijlstra, Felix
AU  - Zijlstra F
FAU - Piek, Jan J
AU  - Piek JJ
FAU - Hirsch, Alexander
AU  - Hirsch A
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20120808
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Cell Transplantation/*methods
MH  - Coronary Vessels
MH  - Humans
MH  - Injections, Intra-Arterial
MH  - Myocardial Infarction/physiopathology/*surgery
MH  - Randomized Controlled Trials as Topic
MH  - Transplantation, Autologous
MH  - Ventricular Function, Left/*physiology
EDAT- 2012/08/10 06:00
MHDA- 2013/04/12 06:00
CRDT- 2012/08/10 06:00
PHST- 2012/08/10 06:00 [entrez]
PHST- 2012/08/10 06:00 [pubmed]
PHST- 2013/04/12 06:00 [medline]
AID - heartjnl-2012-302230 [pii]
AID - 10.1136/heartjnl-2012-302230 [doi]
PST - ppublish
SO  - Heart. 2013 Feb;99(4):225-32. doi: 10.1136/heartjnl-2012-302230. Epub 2012 Aug 8.